Citations 3
C1 and C2 Fractures Above a Previous Fusion Treated with Internal Fixation without Fusion
Kolz, Joshua M. , Hobson, Sandra L. , Currier, Bradford L. , Nassr, Ahmad , Currier, Bradford , Nassr, Ahmad N
JBJS Case Connector | May 12, 2021 | Volume: 11 | Issue: 2 | Pages: No page available
Case: A 71-year-old woman sustained C1 lateral mass and type 2 odontoid fractures 3 years after C2-T2 anterior-posterior fusion. She was treated with C1-C4 instrumentation without fusion for 9 months followed by instrumentation removal to restore atlantoaxial motion. After instrumentation removal, she maintained clinically relevant cervical lateral bending, rotation, and flexion and extension. Conclusion: The loss of upper cervical motion after C1-C2 instrumented fusion may be debilitating for patients in the setting of previous subaxial cervical fusion. Temporary instrumentation without fusion may allow for preservation of upper cervical motion in patients with concomitant C1 and C2 fractures above a previous cervical fusion.
Nonsurgical Management of Combined Occipitocervical and Atlantoaxial Distraction Injuries
Kolz, Joshua M. , Christensen, Tyson C. , Diehn, Felix E. , Sebastian, Arjun S. , Currier, Bradford L. , Nassr, Ahmad , Currier, Bradford , Nassr, Ahmad N , Diehn, Felix E
JBJS Case Connector | January 14, 2021 | Volume: 11 | Issue: 1 | Pages: e20.00228-e20.00228
Case: A 41-year-old man sustained occipitocervical dislocation (OCD) and atlantoaxial dislocation (AAD) injuries in a motor vehicle collision. These injuries were treated nonoperatively with a hard cervical collar and activity restrictions with an excellent result at 4-year follow-up. Conclusion: OCD and AAD injuries require prompt diagnosis and immobilization. Standard of care for coexisting injuries is occipitocervical fusion; however, some patients have coexisting injuries which may prevent operative treatment. These polytrauma patients require a creative nonoperative approach with close follow-up to avoid neurologic decline.
Early Implant Failure of a 2-Level M6-Cervical Total Disc Replacement
Clark, Nicholas J. , Francois, Elvis L. , Freedman, Brett A. , Currier, Bradford L. , Currier, Bradford
JBJS Case Connector | July 29, 2020 | Volume: 10 | Issue: 3 | Pages: e19.00644-e19.00644
Case: We report a case of implant failure after primary 2-level M6-cervical disc replacement (M6-C; Spinal Kinetics) at C4-5 and C5-6. At revision surgery, a full-thickness tear was identified in the sheath of the C5-6 implant. Histology from periprosthetic tissue demonstrated polyethylene particles without acute inflammation. Tissue cultures were positive for Propionibacterium acnes , but ultrasonicate cultures were negative for both prostheses. An independent laboratory test confirmed mechanical failure of the C5-6 prosthesis. Conclusion: This is the first report of mechanical failure associated with wear-debris osteolysis after M6-C disc arthroplasty. Therefore, continued surveillance after CTDR is necessary.